Considering a tracheostomy

A tracheostomy may enable you to have ventilation if NIV cannot successfully support your breathing

A tracheostomy is a surgical procedure to make small hole in the windpipe (trachea) at the front of the neck. A small flexible tube is then inserted, allowing a ventilation device to be attached. This then gently pumps air directly into your lungs.

Tracheostomy (also shortened to trache, pronounced “trackie”) is commonly used in intensive care settings to help unconscious patients breathe. This is called invasive ventilation.

A tracheostomy may be useful if you have severe issues with secretions (mucus and saliva), find NIV too uncomfortable, or your breathing difficulties are too advanced for NIV to help.

In the UK, tracheostomies are presently not commonly used for people with MND/ALS. The procedure is done in hospital, and it may take several weeks or longer to arrange the care package needed for you to go home.

Tracheostomies require a higher intensity of care giving, so this must be considered. Depending on the type of tracheostomy used it may affect your ability to speak, eat and drink, if these have not already been affected by MND.

Read the MND Association’s guide to assisted ventilation in External Resources for more detailed information on tracheostomies.